Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach †
Abstract
:1. Introduction
2. Materials and Methods
2.1. MIRAGE Registry
2.2. Surgical Technique
2.3. Definitions and Follow-Up
2.4. Statistical Analysis
3. Results
3.1. Patient and Surgical Characteristics
3.2. In-Hospital Course
3.3. Follow-Up
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | All Patients | PS-Matched Patients | |||||
---|---|---|---|---|---|---|---|
Sternotomy-VSARR (62) | Mini-VSARR (22) | Pvalue | Sternotomy-VSARR (17) | Mini-VSARR (17) | Pvalue | ||
Age, years (median (IQR)) | 39 (28, 52) | 64 (49, 65) | <0.001 | 63 (52, 68) | 53 (48, 64) | 0.143 | |
Male gender | 55 (88.7) | 20 (90.9) | 1.000 | 15 (88.2) | 16 (94.1) | 1.000 | |
Diabetes | 2 (3.2) | 2 (9.1) | 0.280 | 2 (11.8) | 1 (5.9) | 0.209 | |
Smoking | 26 (41.9) | 9 (40.9) | 1.000 | 8 (47.1) | 7 (41.2) | 1.000 | |
Hypertension | 39 (62.9) | 18 (81.8) | 0.119 | 16 (94.1) | 14 (82.4) | 0.601 | |
CVD | 2 (3.2) | 1 (4.5) | 1.000 | 1 (5.9) | 0 (0.0) | 1.000 | |
Hyperlipidemia | 16 (25.8) | 7 (31.8) | 0.589 | 5 (29.4) | 3 (17.6) | 0.280 | |
BMI (median (IQR)) | 25.1 (23.3, 27.8) | 27.8 (25.9, 30.7) | 0.008 | 26.5 (24.6, 30.4) | 27.1 (24.7, 29.3) | 0.953 | |
Pulmonary hypertension 1 | 3 (4.8) | 0 (0.0) | 0.563 | 0 (0.0) | 0 (0.0) | NA | |
Renal impairment | 10 (16.1) | 6 (27.3) | 0.343 | 7 (41.2) | 5 (29.4) | 0.721 | |
NYHA | |||||||
I | 36 (58.1) | 9 (40.9) | 0.215 | 9 (52.9) | 6 (35.3) | 0.491 | |
II | 21 (33.9) | 8 (36.4) | 1.000 | 6 (35.3) | 6 (35.3) | 1.000 | |
III | 5 (8.1) | 5 (22.7) | 0.118 | 2 (11.8) | 5 (29.4) | 0.398 | |
LVEF (%)(median (IQR)) 1 | 55 (51, 60) | 59 (50, 60) | 0.588 | 55 (53, 61) | 59 (50, 60) | 0.968 | |
Previous MI | 1 (1.6) | 0 (0.0) | 1.000 | 1 (5.9) | 0 (0.0) | 1.000 | |
Previous PCI | 0 (0.0) | 1 (4.5) | 0.262 | 0 (0.0) | 1 (5.9) | 0.354 | |
Aortic disease | |||||||
AV stenosis | 2 (3.2) | 0 (0.0) | 1.000 | 1 (5.9) | 0 (0.0) | 0.354 | |
AV insufficiency | 52 (83.9) | 22 (100.0) | 0.057 | 14 (82.4) | 17 (100.0) | 0.227 | |
Bicuspid aortic valve | 27 (43.5) | 1 (4.5) | 0.001 | 3 (17.6) | 1 (5.9) | 0.601 |
Sternotomy-VSARR (17) | Mini-VSARR (17) | Pvalue | |
---|---|---|---|
CPB time (median (IQR)) | 166 (157, 177) | 226 (220, 239) | <0.001 |
Aortic cross clamp (median (IQR)) | 140 (136, 147) | 160 (158, 171) | <0.001 |
In-hospital mortality | 0 (0.0) | 0 (0.0) | NA |
Cardiac tamponade and/or rethoracotomy for bleeding | 3 (17.6) | 2 (11.8) | 1.000 |
Postoperative drainage (mL) (median (IQR)) | 845 (588, 1393) | 740 (485, 1020) | 0.651 |
Periprocedural MI | 0 (0.0) | 1 (5.9) | 1.000 |
Respiratory failure | 0 (0.0) | 1 (5.9) | 1.000 |
Neurologic complications | 0 (0.0) | 0 (0.0) | NA |
Multiorgan failure | 0 (0.0) | 1 (5.9) | 1.000 |
Acute kidney failure and/or dialysis | 0 (0.0) | 1 (5.9) | 1.000 |
Sternal wound infection | 0 (0.0) | 1 (5.9) | 1.000 |
ECMO | 0 (0.0) | 1 (5.9) | 1.000 |
IABP | 0 (0.0) | 0 (0.0) | NA |
HLoS (median (IQR)) | 9.50 (8.00, 11.00) | 6.52 (4.92, 9.35) | 0.031 |
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Staromłyński, J.; Kowalówka, A.; Gocoł, R.; Hudziak, D.; Żurawska, M.; Nowak, W.; Pasierski, M.; Sarnowski, W.; Smoczyński, R.; Bartczak, M.; et al. Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach. J. Clin. Med. 2024, 13, 2692. https://doi.org/10.3390/jcm13092692
Staromłyński J, Kowalówka A, Gocoł R, Hudziak D, Żurawska M, Nowak W, Pasierski M, Sarnowski W, Smoczyński R, Bartczak M, et al. Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach. Journal of Clinical Medicine. 2024; 13(9):2692. https://doi.org/10.3390/jcm13092692
Chicago/Turabian StyleStaromłyński, Jakub, Adam Kowalówka, Radosław Gocoł, Damian Hudziak, Małgorzata Żurawska, Wojciech Nowak, Michał Pasierski, Wojciech Sarnowski, Radosław Smoczyński, Maciej Bartczak, and et al. 2024. "Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach" Journal of Clinical Medicine 13, no. 9: 2692. https://doi.org/10.3390/jcm13092692
APA StyleStaromłyński, J., Kowalówka, A., Gocoł, R., Hudziak, D., Żurawska, M., Nowak, W., Pasierski, M., Sarnowski, W., Smoczyński, R., Bartczak, M., Brączkowski, J., Sadecka, S., Drobiński, D., Deja, M., Szymański, P., Suwalski, P., & Kowalewski, M. (2024). Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach. Journal of Clinical Medicine, 13(9), 2692. https://doi.org/10.3390/jcm13092692